FFP Compatibility

A pale, tired-looking 65 yo F presents to your ED c/o bright red blood per rectum. When taking her history, you find out she takes Coumadin.
The labs you order return; most notably, her INR is 7.2.
You call up the lab to start thawing some FFP.
They send Blood Type AB, but… your patient is Blood Type A.
Was there a mix-up? Nope…

A quick refresher from Medical School:
If you belong to the blood group AB, you have both A and B antigens on the surface of your red blood cells and no A or B antibodies at all in your blood plasma.
If you belong to the blood group 0, you have neither A or B antigens on the surface of your red blood cells but you have both A and B antibodies in your blood plasma.

So what if a Type AB pt were incorrectly given Type O donor FFP? Well, the plasma of the Type O would retain anti-A & anti-B antibodies in its plasma, which would go on to attack the pt’s Type AB RBC antigens:

Other Quick Fixes –
PRBC:
We all know that the universal donor for packed red cells is “O” and in the case of females of child-bearing age, specifically O-neg PRBC. Many hospitals now have thawed PRBC’s available for immediate transfusion in the critically ill, specifically trauma patients. Most commonly O-neg is used. In study done at Maryland Shock Trauma (Dutton, J Trauma 2005. http://www.ncbi.nlm.nih.gov/pubmed/16394920) O-neg was only used for female pt’s of child-bearing age and O-pos for all other pts. There were no transfusion reactions noted in the almost 581 transfusions given to 181 pt’s.
1 unit PRBC is 225cc and generally raises Hct by 3

FFP:
1 unit of FFP is 250cc with a standard dose of 10cc/kg (2-3units)
Apheresis FFP is 500 or 750cc from single donor